Complaint filed on: 12-07-2018

                                                     Disposed on: 05-03-2021

BEFORE THE DISTRICT CONSUMER DISPUTES

REDRESSAL COMMISSION, TUMAKURU

CC.No.60/2018

DATED THIS THE 5^th DAY OF MARCH, 2021

PRESENT

SRI.C.V.MARGOOR, B.Com, L.L.M, PRESIDENT

SRI.KUMARA.N, B.Sc., L.L.B, MEMBER

SMT.NIVEDITA RAVISH, B.A., L.L.B, LADY MEMBER

Complainant: -

Nagaraja.E

S/o late Eranagappa, Major,

R/o Marammana halli village,

Y.N.Hosakote post,

Pavagada Taluk,

Tumakuru district

(By G.H.R. & Associates)

V/s

Opposite parties:-    

1. The Manager,

CPC (PIL/RPLI)

Department of Post,

O/o the Post Master,

Tumakuru-572 101

2. Chief Postmaster General (PLI), Karnataka Circle,

Palace Road,

Bengaluru -560 216

3. Senior Superintendent

DDM (RPLI)/ADM (RPLI),

Rural Postal Life Insurance,

Tumakuru division,

Tumakuru-572101

(OP No.1 and 2- Exparte)

(OP No3-by Sri.H.S.Raju, Advocate)

ORDER

SRI.C.V.MARGOOR, PRESIDENT

This complaint is filed under Section 12 of the Consumer Protection Act, 1986 to direct the Opposite parties (hereinafter called as OPs) to pay insurance claim bearing policy No.R-KT-EA-702769 dated 5-2-2011 for a sum of Rs.1,00,000=00 with interest @ 16% p.a. and also to pay compensation of Rs.1,00,000=00 for mental harassment and damages.

2. It is the case of complainant that his father by name Eranagappa had taken Rural Postal Life Insurance (hereinafter called as RPLI for brivity) under a scheme Santosh on 5-2-2011 for a sum of Rs.1,00,000=00 from the OPs by agreeing to pay monthly premium of Rs.599=00. Date of maturity of the policy is on 17-01-2026. The father of complainant was paying monthly premium regularly and due to ill-health he was passed away on 11-6-2015. The complainant is nominee to the policy taken by his father. After the death of Eranagappa, the complainant has submitted claim application but the OPs have repudiated the claim stating that the deceased has suppressed his age as 44 years on the date of taking policy in fact he was aged more than 55 years on the date of issue of policy hence, this complaint.      

3. In response to notice the 3^rd OP has appeared through its learned counsel and filed written version admitting that the deceased was endowment assurance policy holder bearing No.R-KT-EA-702769 dated 5-2-2011 for a sum of Rs.1,00,000=00 for which the complainant is the nominee. It is further admitted by the 3^rd OP that the deceased was paying the monthly premium regularly. The OP case is that when the deceased was admitted in the hospital in the year 2015 he disclosed his age as 60 years before the doctor and from the hospital record they came to know that the deceased has suppressed his age at the time of taking policy as such this OP has repudiated the claim. Due to suppressing the age by deceased he was to pay less premium as the maximum limit of sum assured with no standard proof of age shall be Rs.1,00,000=00. The 5% extra premium will be levied on the policies with sum assured of more than Rs.25,000=00 subject to usual medical examination. Further if any one taking polices worth of Rs.25,000=00 with non standard proof of age shall not be beyond 45 years of age. The deceased has suppressed the age by 10 years while taking the policy stating his age as 44 years on the date of issuing of policy. Therefore, the OP No.3 has not committed any deficiency of service in repudiating the claim of complainant. On the above grounds, the 3^rd OP asked to dismiss the complaint.   

4. The OP No.1 and 2 despite the service of notice were proceeded exparte.

5. The complainant has filed his affidavit evidence and produced 24 documents in support of his case. That one V.R.Swamy, Superintendent of Post office, Tumakuru Division has filed his affidavit evidence on behalf of the 3^rd OP.

6. We have heard the oral arguments advanced by the learned counsel representing the complainant in addition to that the complainant and 3^rd OP has submitted written brief and the points that would arise for determination are as under:

1. Whether the complainant proves that the repudiation intimation issued by the OPs is improper and not justifiable?
2. Is complainant entitled to the reliefs sought

for?  

7. Our findings on the aforesaid points are as follows:

Point No.1: In the affirmative  

Point No.2: In the partly affirmative for the

below

REASONS

8. Point No.1 to 2: The learned counsels for the complainant and OPs in their written arguments have reiterated more or less of the averments of complaint and written version. The complainant has produced original RPLI policy document which contained the date of commencement of risk as 17-1-2011 and date of maturity is 17-1-2026. It is mentioned in the policy that the deceased/insured Eranagappa age at entry 45 years. On the back page of policy document Clause 2.3 under heading proof of age it is printed as:

“In the event an insured advised a lower age than his/her correct age and was paying a premium lower than that required for continuance of the policy, depending on his/her correct age then such policy will be declared to be void and no benefit will be payable under this policy. However, the Chief Postmaster General, Karnataka circle, Palace road, Bangalore-560216, at his absolute discretion may allow the insured to continue to pay premium based on correct age from current date provided that; any shortfall in the premium already paid accumulated with interest at a rate 12% per annum for the period between, the dates of payments  of such premium and the date of payment of correct premium is paid as single lump sum by the specified date alternatively, he/she may be allowed to continue to pay the correct premium from current date, shortfall of the premium already paid accumulated @12% per annum for the period between the dates of payment of such premium and last premium pay able may be deducted from the settlement amount at the time of setting the claim. Further, in any event if it is found that depending on his/her correct age the policy could not have been issued than such policy issued will be treated as void and no payment will be made”.        

          9. According to the OPs the insured /deceased was aged 55 years at the time of taking the policy in the year 2011. If the OPs had suspension about age of insured at the time of issue of policy they would have sent the insured for medical examination to test his age. The medical officer would have given approximate age by examining bones, teeth etc. and the opinion of medical officer is acceptable subject to variation of two years more or less. The deceased Eranagappa was illiterate and he had no documents to show his age at the time of taking policy from the OPs. When the deceased had no document with regard to his date of birth, then the duty cast upon the OPs to get the medical examination of the deceased to know his approximate age. It was the negligence on the part of OPs at the time of issuing the policy as such after the death of deceased the OPs cannot raised objections that the deceased has given false age at the time of taking policy. There is no dispute by the OPs with regard to issuing RPLI policy in the name complainant’s father for a sum of Rs.1,00,000=00 on 17-1-2011 and payment of monthly premium regularly till his death on 11-6-2015.

          10. The learned counsel for complainant with regard to disputing the age of insured/deceased after his death relied upon the case of M/s Sahara India Commercial Corporation Ltd through its Sector Manager –vs- Smt.Rasal Devi Meghwanshi and Anr – 2013 (4) CPR 90 (NC); Sub Postmaster & Anr -vs- Santosh Kaur – 2013(1) CPR 33 (NC); Post Master office, Taluka Sindkheda and Anr –vs- Shri Samadhan Subash Patil – 2012 (4) CPR 80 (NC); ICICI Lombard General Insurance Co. Ltd –vs- Surendra Kumar Tikkiwal First Appeal No.541/2017 dated 28-5-2018 Judgment delivered by the Hon’ble State Consumer Disputes Redressal Commission, Rajasthan, Jaipur Bench No.1. Lastly the complainant relied upon the case of Azaz Haider –vs- LIC of India – 2017 (1) CPR 818 (NC) wherein under Sections 15, 17, 19 and 21 of CP Act, 1986 held as under;

“Insurance-repudiation of death claim on ground that insured had declared false age while filling proposal form. Policy was issued after due verification by office of OP and examination of panel of LIC doctors. It clearly indicates unfairness on part of OP to save a meager sum of Rs.50,000=00. Dragging innocent illiterate consumer from District Forum to National Commission itself shows that OPs are bent upon harassing such like consumers who have kept utmost good faith of such insurance companies. Family members of deceased are struggling to avail genuine claim of Rs.50,000=00 for almost two decades. Order of State Commission set aside and order of District Forum restored with modification that OP shall pay insured amount to complainant along with 9% interest, Rs.20,000=00 as compensation towards mental agony and Rs.10,000=00 as litigation costs.”     

          11. The facts of the above citation are similar to the facts on hand. In this case the OPs were not prevented from getting examination of the insured Eranagappa from medical officer to confirm his age before accepting his proposal of RPLI though the insured had no documents with regard to his date of birth as he was illiterate. The OPs have accepted the age and issued policy and they have never raised the objections from the year 2011 till the death of insured/deceased or receiving the claim application. Only after receiving the claim application the OPs have come up with the objections that the deceased has given false age at the time of taking policy. In view of the decisions rendered by the Hon’ble National Consumer Commission – 2017 (1) CPR 818 (NC) (cited supra) the complaint deserve to be allowed. The OPs have not placed any material to show that the deceased/insured has given false age or suppressed his age at the time of submitting the proposal or issue of policy. Therefore, the repudiation of claim of complainant made by the OPs is not justifiable. The OPs shall liable to pay a sum insured amount of Rs.1,00,000=00 with interest @ 8% p.a. from the date of death of insured till its payment. In addition to that the OPs shall pay Rs.10,000=00 as compensation for harassing the complainant i.e. mental suffering and litigation cost of Rs.10,000=00. In the result, we proceed to pass the following;

ORDER

The complaint filed by Sri.Nagaraja.E is partly allowed directing the OP Nos.1 to 3 jointly and severally liable to pay a sum of Rs.1,00,000=00 with interest @ 8% p.a. from 12-6-2015 till the date of payment.

It is further ordered that the OP Nos.1 to 3 shall pay compensation of Rs.10,000=00 and litigation cost of Rs.10,000=00 to the complainant within 45 days from the date of order. Otherwise the said amount carries interest @ 8% p.a. from the date of filing complaint till the date of payment.

Furnish the copy of order to the complainant and opposite parties at free of cost.